Posted by Jedi on November 27, 2007, at 3:12:43
In reply to MAOI's, Treatment resistant depression., posted by sonic_gb on November 26, 2007, at 9:58:27
Hi,
Sounds like you are Canadian. I've found a general lack of knowledge about the irreversible MAOIs in Canada; at least among the pharmacists. Let's hope that your psychiatrist has some knowledge of the meds.I always write an introduction letter when I am seeing a new doctor. This stategy can backfire depending on the personality of your MD. If your depression is atypical; phenelzine, tranylcypromine, or isocarboxazid will be your best choices. Despite the name, atypical depression is really the most common type of depression. In addition to the core symptoms of depression, atypical depression is defined by the ability to feel better temporarily in response to a positive life event, plus any two of the following criteria: excessive sleep, overeating, a feeling of heaviness in the limbs and a sensitivity to rejection.
I usually print out a few citations from Pubmed that show the efficacy of the irreversible MAOIs on atypical depression. If you have social anxiety disorder along with the depression, Nardil or Marplan decrease the metabolism of GABA which can really help this disease. Like I said this startegy can backfire depending on the ego of your psychiatist and his willingness to listen to the patient.
Good Luck,
JediReferences:
> Hello All,
>
> I have my first appointment with a psychiatrist next week. I am in the middle of a worsening period of major depression and anxiety that isn't responding to any drugs tried so far. I have had multiple treatment failures with various AD's. I have tried at least 5 different SSRI's, nefazodone, Effexor, Remeron, Wellbutrin SR, and Moclobemide. Out of all of those Moclobemide (a reversible MAOAI) worked best, but pooped out after three short great weeks. I would like to ask to be put on "real" MAOI, either Parnate or Nardil, since I had a good experience previously on a mini-MAOI. Apparently neither MAOI is really prescribed in my country except in extreme cases.
>
> How should I present my case? Is there anything else that I should be considering at this point? This may be my only chance to see the psychiatrist, since there is a big shortage here, and they are "rationed" by the province.
>
> Please help me prepare, I really need to feel better.
>
> Thanks,
>
> Sonic
poster:Jedi
thread:797131
URL: http://www.dr-bob.org/babble/20071125/msgs/797260.html